Headaches are something that many of us struggle with regularly. Some headaches can be minor while others can bring throbbing and uncomfortable pain. Everyone will experience headaches at one time or another, but the symptoms, cause and treatment can vary:
Distinguishing headaches
Before covering the different types of headaches, we’ll make the distinction between episodic and chronic headache disorders.
Episodic headaches – these are headaches that occur for no more than 15 days within a given month. Episodic headache attacks can last between 30 minutes to several hours.
Chronic headaches – chronic headaches occur for more than 15 days within a given month. As they are much more consistent, this type of headache disorder will require a pain management plan.
Headaches are also classed as either primary or secondary:
Primary headaches are those without an underlying cause. These headaches are usually not serious to our long-term health and are usually triggered by lifestyle factors.
Secondary headaches are a result of an underlying health issue or cause and will require medical attention to relieve such headaches.
The types of headaches
Now we’ve covered the difference between episodic and chronic headaches, let’s look at the different headache types.
Tension headache
Tension headaches are the most common type of headache people experience. Tension headaches can vary from mild or moderate pain to intense pain in your head, neck and behind the eyes. These headaches are classed as primary.
Tension headaches are usually episodic and occur around once or twice a month. However, they can also be chronic headaches. Tension headaches can be described as a tight band around your head. Other symptoms of tension headaches include:
- A dull pain in the head
- Slight pressure or tenderness around your forehead
- A difficulty in focusing your vision
- The feeling of fatigue or irritability
Tension headaches do not give nausea or vomiting symptoms. Tension headaches are also sometimes confused with migraine. Migraine, however, has different symptoms, including much more intense head pain.
Even though tension headaches are the most common, the exact cause is still unknown. However, many factors can lead to tension headaches. Factors that can cause this type of headache include:
- Muscle tension and stress
- Eye strain or dry eyes
- Smoking or drinking alcohol
- Not drinking or eating enough
- A lack of sleep or fatigue
- Emotional stress
- Excessive caffeine
Tension headaches can usually be relieved easily without the need to take any medication. Ensuring you stay hydrated and get sufficient sleep will help alleviate tension headaches. Minimising stress and muscle tension alongside balancing your caffeine intake will also help.
If you regularly suffer from tension headaches, keep a diary tracking what food, drinks, or activities you feel may cause the headache. Before long, you’ll be able to establish a connection between the headache and the trigger.
Sinus headaches
If you’ve ever experienced a headache during a cold or flu, you’ve suffered from a sinus headache. Sinus headaches happen when the sinus experiences pressure because of mucus build-up.
Mucus build-up can happen because of illness, allergies, or dry weather. Sinus headaches express the pain in the forehead, the nasal bridge, or in the cheekbones. Moving the head with sudden movements can increase pain.
Sinus headaches are usually relieved once the pressure on the sinus is gone. Thinning out the mucus causing the pressure can help. In this instance, sinus headaches are usually relieved once the illness has passed.
Sinus headaches can also be a sign of a sinus infection. In this instance, you will need prescribed antibiotics to cure the headache. Sinus headaches are a form of primary headaches.
Cluster headaches
Cluster headaches, as the name suggested, happen in clusters. Cluster headaches can be considered the worst type of headache, bringing an intense or burning sensation behind or around the eyes.
Symptoms of cluster headaches can include:
- a constant or throbbing pain, with the pain so intense that people are unable to remain still
- eyes can tear up or become red on the side experiencing pain
- pupil can shrink in the eye on the side experiencing pain
- eyelids can droop
- the face can become sweaty
- nostril can become blocked or runny
Cluster headaches are experienced in groups, hence the term cluster. During a cluster period, someone can experience a headache between one and three times a day. A cluster period can last anywhere between 2 weeks to 3 months. A headache attack will last for between 15 minutes to 3 hours.
Cluster headaches can also disturb sleep too. Cluster headaches can disappear entirely for months or years, known as remission, before coming back. Men are much more likely to experience cluster headaches compared to women.
Unfortunately, the cause of cluster headaches is still unknown. However, these headaches have been linked to activity within the hypothalamus part of the brain. It is also suggestive that people who smoke are more likely to suffer from cluster headaches.
There could also be a genetic link, where there’s a family history of people suffering from cluster headaches. Strong scents can also trigger these headaches (such as petrol or perfume) or drinking alcohol.
Migraine
In the UK, it is estimated around 190,000 migraine attacks happen every day with around 6 million people experiencing the pain and disability of migraine disease. Migraine is a type of headache disorder that affects around 1 in every 5 women and 1 in every 15 men.
Migraine attacks can range from moderate head pain to severe head pain. It is often felt as a throbbing pain on one side of the head. Other symptoms are also often experienced including sickness and increased sensitivity to sound and light.
Migraine attacks are unusual in that they can express an aura. They can occur with an aura, or an aura without the headache. Auras mostly precede the headache and can be described as a temporary visual disturbance.
A migraine headache attack will usually develop within an hour after an aura. An aura can last for up to 60 minutes. The frequency of migraine attacks is different for everyone living with migraine disease. Some may experience them on a regular, even daily basis. Others can experience them occasionally.
Migraine is a type of headache disorder that most commonly begins in childhood and early adulthood. It is less likely to develop with advancing age and during pregnancy. Migraine attacks are related to blood vessel contractions alongside other brain changes (although the exact cause is still unknown).
Triggers of migraine attacks can include:
- Certain foods and drinks
- Stress
- Hormone changes or starting your period
- Changes in sleeping pattern or tiredness
- Family history of migraines
There is no cure for migraine disease. However, there are options available to help treat the pain and reduce symptoms, including:
- External Trigeminal Nerve Stimulation device (e-TNS)
- Painkillers
- Triptans
- Anti-emetics
- Sleeping or lying in a dark room
- Avoid a known trigger
Maintaining a healthy style by eating a balanced diet, getting plenty of exercise, maintaining caffeine consumption and sufficient sleep can help to reduce migraine attacks. Regular and severe migraine attacks may benefit from preventative treatments, available by seeing your GP.
Hormone headaches
Hormone headaches are experienced by women as a result of hormonal fluctuations. Anything from menstruation, pregnancy, menopause, or hormonal contraceptives can change oestrogen levels that result in hormone headaches.
It is estimated that 60% of women who experience migraines are also likely to suffer from hormonal headaches or menstrual migraines. Menstrual migraines develop due to a decrease in oestrogen levels either before a period or at the start of a period.
Keeping a diary of 3 menstrual cycles will help to identify if the headaches are linked to your period and what stage in your period cycle. There are some self-help treatments you can try to minimise or prevent hormone migraines, these include:
- Eating small and frequent snacks that will keep your blood sugar levels high.
- Avoid missing meals or going for prolonged periods without any food
- Try to keep a regular sleeping pattern and make sure to get sufficient sleep each night
- Avoid stress or keep stress to a minimum
In cases where hormonal headaches do not resolve with these treatments, you may be able to access further treatments from your GP. Hormone headaches are a form of secondary headaches and will require the cause of the headache to be treated.
Hypertension headaches
Hypertension headaches are referred to as a secondary headache. Hypertension headaches are caused as a result of an underlying health issue. While high blood pressure can lead to hypertension headaches, in most cases this is not the cause.
Hypertension headaches cause a pulsating or throbbing pain felt on both sides of the head. Reducing your blood pressure can help to alleviate hypertension headaches. It is suggested that more the intense the pain, the higher your blood pressure.
Reducing your blood pressure should help to reduce hypertension headaches. However, monitoring your blood pressure is extremely important, as any increasing spikes can be a sign of a much more serious health issue. If your blood pressure remains high, you should seek medical advice as quickly as possible.
Other types of headache
Other types of headaches you can also experience include:
- Caffeine headaches – from consuming too much caffeine (primary)
- Hangover headaches – from drinking too much alcohol (primary)
- Head injury headaches – developing because of a head injury (secondary)
- Medication overuse headaches – resulting from taking certain medications (secondary)
- Hypnic headaches – can occur in advanced years, waking people up during the night (primary)
- Exertional headaches – resulting from strenuous physical exercise (primary)
Headaches can put a dampener on anyone’s day. While we all will experience a headache at one time or another, recurring and severe headaches are a warning sign. These headaches, known as secondary headaches, will need medical attention as quickly as possible.
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